Khatkov I E, Lesko K A, Dubtsova E A, Khomeriki S G, Karnaukhov N S, Vinokurova L V, Shurygina E I, Makarenko N V, Izrailov R E, Savina I V, Salimgereeva D A, Kiriukova M A, Bordin D S
Loginov Moscow Clinical Scientific Center.
Russian University of Medicine.
Ter Arkh. 2024 Sep 14;96(8):780-789. doi: 10.26442/00403660.2024.08.202831.
To evaluate the possibilities of post-processing of multidetector computed tomography (CT) results in the non-invasive diagnosis of pancreatic fibrosis (PF).
The study included 165 patients aged 57.91±13.5 years who underwent preoperative CT during surgical treatment for chronic pancreatitis and pancreatic cancer from April 2022 to February 2024. The normalized contrast ratios of pancreatic tissue in the pancreatic (NCPP) and venous (NCVP) phases, as well as the contrast ratio (CR) were measured. Pathomorphological assessment of PF performed in tissues outside neoplasm or desmoplastic reaction by the Kloppel and Maillet scale.
The values of post-processing CT results were compared in groups with different degrees of PF. Mean CR values were significantly higher (0.001) in patients with severe PF (CR 1.16±0.65 HU) than in patients with mild PF (CR 0.78±0.31 HU). CR value significant increase (0.03) was found in patients with signs of inflammatory changes in the pancreas tissue (CR 1.14±0.6 HU) than in those without them (CR 0.81±0.3 HU). There were no significant differences between the values of NCPP and NCVP, and the degree of PF.
The CR value increased in patients with severe degree of PF. There was a relationship between CR value increase and the radiological density of pancreatic tissue in non-contrast phase and presence of early signs of pancreatic inflammatory changes. Thus, there was a relationship between CT postprocessing results and morphological signs of PF, which can be used for pancreatic fibrosis non-invasive diagnosis and identification of additional signs of early chronic pancreatitis.
评估多排螺旋计算机断层扫描(CT)结果后处理在胰腺纤维化(PF)无创诊断中的可能性。
本研究纳入了165例年龄为57.91±13.5岁的患者,这些患者在2022年4月至2024年2月期间因慢性胰腺炎和胰腺癌接受手术治疗,术前均进行了CT检查。测量了胰腺期(NCPP)和静脉期(NCVP)胰腺组织的归一化对比率以及对比率(CR)。通过Kloppel和Maillet量表对肿瘤外或促结缔组织增生反应的组织进行PF的病理形态学评估。
比较了不同PF程度组的CT结果后处理值。重度PF患者(CR 1.16±0.65 HU)的平均CR值显著高于轻度PF患者(CR 0.78±0.31 HU)(P<0.001)。胰腺组织有炎症改变迹象的患者(CR 1.14±0.6 HU)的CR值显著高于无炎症改变迹象的患者(CR 0.81±0.3 HU)(P=0.03)。NCPP和NCVP值与PF程度之间无显著差异。
PF重度患者的CR值升高。CR值升高与胰腺组织非增强期的放射密度以及胰腺炎症改变的早期迹象存在关联。因此,CT后处理结果与PF的形态学征象之间存在关联,可用于PF的无创诊断以及早期慢性胰腺炎附加征象的识别。